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Picking single leader among pre-Easter conditions for £1.8bn bailout

England’s largest healthcare bodies have published a checklist of key targets trusts must meet before Easter in their path towards developing ‘sustainability and transformation’ plans (STPs) – including nominating a single person to oversee and co-ordinate the STP process.

The milestones were attached to a letter sent to chief executives and CCG officers dated yesterday from the bosses of the CQC, Health Education England, NICE, NHS Improvement, Public Health England and NHS England.

The plans were laid out in NHS England’s planning guidance for the next five years, published in December. They form part of a two-pronged planning footprint that all trusts must adhere to in order to recover from financial deficit and safeguard future sustainability.

A £1.8bn bailout fund provided by the government will also be entirely contingent on trusts’ compliance with a series of “strict and non-negotiable” conditions, including strong recovery plans for the short and long term.

The letter confirms: “The STPs will become the single application and approval process for being accepted onto programmes with transformation funding for 2017-18 onwards. This step is intended to reduce bureaucracy and help with the local join-up of multiple national initiatives.”

Before Easter, trusts must nominate a “senior and credible leader” responsible for overseeing this hefty process – a named person who can “command the trust and confidence of the system”, such as a CCG chief officer, a chief executive or a council boss.

“They will be responsible for convening and chairing system-wide meetings and facilitating open and honest conversations that will be necessary to secure sign-up to a shared vision and plan,” the letter said.

“We would expect to see time and resource dedicated to this system leadership role.”

As well as establishing the necessary governance arrangements to carry STPs forward, trusts must “quickly get a sense” of the scale of the challenges in their local area by working out the extent of the ‘gaps’ across their health and care system.

These gaps, highlighted in the Five Year Forward View, include health and wellbeing, care and quality, and finance and efficiency.

This process will be accelerated by analytical support provided by NHS England, who will publish greater detail on this on 29 February.

“This will set out the key health and well-being outcomes the NHS and partners need to improve by preventing illness, diagnosing disease earlier and treating it more effectively; the quality improvement and service change priorities by 2020, such as moving to seven day services and (by the end of March) provide each area with analytical support to help assess its financial gap,” read the letter.

Also until Easter, analysed information will be shared using some of the tools Vanguards find useful, including “logical models” that form a basis for longer-term planning.

Acknowledging that “there is clearly a lot to do in a short space of time”, the NHS leaders said each STP footprint will be asked to attend one of four regional ‘development days’ to share their “emerging thinking” with national chief executives.

After Easter, the letter said, local area partners will be able to focus on the detail of their plans and the actions needed to close the three gaps over the next five years.

A good STP will also be able to set out how areas will “maintain and deepen” the progress they will make by implementing operational plans, the second leg of the two-pronged planning model.

These operational plans must outline how trusts will deliver the ‘key must-dos’ from an overarching list of nine essential ‘must-dos’ set out in NHS England’s planning guidance.

Later, in April and May, national NHS bodies will hold regional workshops and webinars to provide practice help with developing plans, alongside making available online collaborative tools where local providers can share examples of best practice.

The letter also repeated the Department of Health’s intention to grow the sustainability and transformation fund of £1.8bn to £2.9bn in 2017-18 and £3.4bn in 2020-21, with an “increasing share” of the fund dedicated to transformation rather than sustainability as trusts balance their books.